The purpose of this form is to provide information and to obtain your consent to engage in psychology services with Neurokin Psychology. This information is current as at 01/01/2026. This form helps to ensure the welfare, satisfaction, and privacy of our clients. If you have any questions about this service agreement, feel free to email: admin@neurokinpsychology.com.au

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Privacy

 

Psychological Service

Neurokin Psychology needs to collect and record personal information from you that is relevant to your situation, such as your name, contact information, medical history and other relevant information as part of providing psychological services to you. This collection of personal information will be a necessary part of the service that is conducted. 

 

Purpose of Collecting and Holding Information

Your personal information is gathered as part of your service, is kept securely and, in the interests of your privacy, used only by your psychologist and the authorised personnel of the practice (as necessary). This practice is subject to the Privacy Act 1988 and must comply with obligations related to the collection, use and disclosure of personal information, including through telehealth services.  

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Your personal information is retained in order to document what happens during sessions and enables the psychologist to provide a relevant, ethical, and informed psychological service to you. To meet Australian privacy legislation all data is stored in Australia and with strict adherence to the Australian Privacy Principles.

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During the course of your engagement with Neurokin Psychology, you may be asked to complete online assessment measures hosted by other third-party platforms (e.g. WPS Publish, Novopsych, Parinc, and others).  These platforms have been selected as they similarly adhere to Privacy Principles, and you can view their respective data security policies via their websites. All clients retain the right to refuse or withdraw consent to provide personal data using these platforms. Raw data and interpretive scores and reports will be saved within your electronic file on our practice management software. Many of the tests are not able to be released to a client directly. 

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Neurokin Psychology stores personal records electronically in your client file on practice management software Halaxy, which you consent to as a client (or parent/carer/guardian) of this practice. Halaxy has strict data security protocols.

Payments for services can be made via direct deposit (bank transfer), or credit/debit card (via Halaxy). You can view the privacy and data protection policies of Halaxy on-line.

 

Access to Client Information

As part of providing psychological services, relevant personal information to the current situation will be collected and recorded in Halaxy. Your psychologist is required by law to keep your file for a minimum of 7 years after your last contact with Neurokin Psychology. If you are under the age of 18 at the time of treatment, the information is mandated to be retained until you are 25 years of age. Personal information pertaining to clients who identify as Aboriginal and Torres Strait Islander must be kept permanently. You may access the information in your file on request, subject to the exceptions in the National Privacy Principles. In this instance, you will be encouraged to arrange a session with your psychologist to discuss the content of your file and any foreseeable risks of releasing this personal information. Fees apply for file preparation, review, and a session (or sessions) to go through this data.

 

Disclosure of Personal Information

All personal information gathered by the psychologist during the provision of the psychological service will remain confidential except when:

• it is subpoenaed by a court, or disclosure is otherwise required or authorised by law; or

• failure to disclose the information would in the reasonable belief of the psychologist place you or another person at serious risk to life, health or safety; or

• your prior approval has been obtained to:

  • a) provide a written report to another professional or agency. e.g., a GP or a lawyer; or

  • b) discuss the material with another person, eg. a parent, employer, health provider or third-party funder; or

  • c) disclose the information in another way

• you would reasonably expect your personal information to be disclosed to another professional or agency and disclosure is directly related to the primary purpose for which it was collected such as to inform your GP of treatment and progress; or

• consultation with another professional is required to provide better services (identifying details will remain confidential).

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If during the course of your work with the psychologist, they become aware of risk to someone’s life, health, or wellbeing, your psychologist is required by policy of the state and federal governments to report the matter to the appropriate agencies. 

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If you have failed to pay us for our services, we reserve the right to apply to the Smalls Claims Tribunal and/or a debt collector in order to recover costs. In this instance, we will be required to disclose basic information about you (name, DOB, address, invoice/fee information, service provided, and dates as to when provided) in order to proceed with this. We reserve the right to claim for the loss of income in addition to the cost to apply to the Small Claims Tribunal. 

 

Mandatory Reporting

This practice adheres to a mandatory reporting policy and your psychologist is required by law to report any disclosures of harm, including but not limited to, child sexual assault, physical abuse, or neglect, to the relevant authorities. Your psychologist will notify you if they receive information relating to you that a child under 18 years of age within your care is at risk, and that the psychologist must report such information to the state child protection agency / Police.

 

Supervision

Psychologists in Australia are required to engage in continuing professional development, peer consultation, and supervision. At times it may be necessary for your psychologist to discuss your presenting issues, case formulation, assessment results, treatment plan, and/or diagnostic report with their supervisor or peers to ensure ongoing quality assurance. Confidentiality is of utmost importance and all de-identifying details are removed before supervision is sought. The supervisor and professional peers are bound by the same confidentiality rules as your psychologist. As a client of Neurokin Psychology (or parent/carer/guardian), we will ask you to get your informed consent on the possibility of your case being reviewed within a supervision capacity- this is your choice, and you can decline at any stage.

 

Evaluation

Assessment information may be utilised for research and service evaluation purposes, but this is only with your consent. All identifying information and names are removed prior to such usage. You have the right to withdraw participation in research at any time, even if you originally gave your consent.

 

Electronic Consent

We prefer to send all information and communication electronically, preferably by email and text message (sms). You may remove your consent to receive electronic communication at any time by written notice. Neurokin Psychology does not currently have provisions to send hard copy correspondence by mail. 
 

Concerns

If you have a concern about the management of your personal information, please notify us. Upon request you can obtain a copy of the Australian Privacy Principles, which describes your rights and how your personal information should be handled. We ask that you give us the opportunity first to deal with your complaint, however, if you wish to lodge a formal complaint about the use of, disclosure of, or access to, your personal information, you may do so with the Office of the Australian Information Commissioner by phone on 1300 363 992, online at http://www.oaic.gov.au/privacy/making-a-privacy-complaint or by post to: Office of the Australian Information Commissioner, GPO Box 5218, Sydney, NSW 2001.

 

Therapy and Therapy Fees

The APS National Schedule of Recommended Fees 2025/2026 has set the standard consultation fee for a psychologist at $330 for a 50-minute session.

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The cost of a standard consultation with the Principal Psychologist at Neurokin Psychology is $330 (50-minute session). Your card details will be saved in a secure database (Halaxy), and payment will automatically be processed on the day of your session. You may be eligible for a Medicare rebate ($145.25) with an appropriate Mental Health Care Plan and referral, and this can be processed on your behalf. If you have any problems with Medicare sending you the rebate, you will have to follow up with Services Australia for yourself due to confidentiality limitations. Fees are subject to change and are reviewed each January and July. Please note that our software program charges a 1.8% card fee for all transactions. You can choose to instead make a bank transfer- our bank details are on your invoice. Bank transfer does not cost anything additional.

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You will be required to pay up front and organise a reimbursement from your funding body after the session. Neurokin Psychology does not bill third parties directly for your consultation. 

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Any additional correspondence (face-to-face, phone, email) with other professionals, agencies and organisations (at the request of a client) or consultations with the psychologist outside of the organised appointment, will be charged at the standard rate ($330), charged in 15 minutes of correspondence/communication. This includes treatment summary reports, letters of support, and/or request for accommodations for workplaces or educational institutions.

Bulk billing is not offered at this clinic. This clinic does not offer reductions in fees due to having a Health Care Card or Pension- we already have a number of long-term / pre-existing clients whom we bulk bill to ensure that they can continue to have access to mental health care.

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The first few therapy sessions will involve a comprehensive evaluation of your needs. As you move through the evaluation, you will be offered some first impressions of what the work will include and a treatment plan to follow. If you have questions about our treatment plan or chosen methodology, you are encouraged to discuss them whenever they arise. You are able to cease your service with your clinician at any time. If you feel uncomfortable with what is happening in a session you may request for the session to cease at any time, and this will not disadvantage you in subsequent help-seeking efforts.

 

Cancellation fees for therapy clients are as follows:

• More than 48 hours (2 business days) notice - Refund provided**

• Between 25 and 48 hours (1-2 business days) notice - 50% of consultation fee**

• Between 0 to 24 hours (less than 1 business days' notice) – No Refund

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Please note any changes to Monday appointments must be confirmed by Thursday of the previous week (i.e. 2 business days), and changes to Tuesday appointments must be confirmed by Friday of the previous week. Weekends and public holidays are not counted as business days. Using a secure payment system (via Halaxy), refunds and late cancellation penalties will be automatically processed.

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Given the limited availability and extensive wait list for Neurokin Psychology, we reserve the right to terminate your agreement and any remaining consultations if you cancel or re-schedule numerous (e.g. 3) appointments and/or are otherwise experiencing significant difficulties engaging with your proposed treatment plan. The outcomes of therapy are often “dose-dependent”, meaning that your psychologist will help you to understand the importance of the timing, consistency, and frequency of your sessions to make the most meaningful changes. Please discuss any barriers to attending regular therapy with your psychologist as soon as difficulties arise.

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Please note that if you arrive late to your session, your session length will be reduced to ensure that the session is still completed in the scheduled time. For example, if you are 10 minutes late, your session will only be 40 minutes maximum. This is to ensure that appointments run to schedule and the following clients are not affected. We reserve the right to cancel the session and record it as a no-show if you are more than 30 minutes late without any communication with your psychologist. In this instance, the no-show cancellation fee will apply (full fee).

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Fees must be paid prior to attending subsequent consultations. We reserve the right to cancel upcoming consultations if you have fees outstanding. We reserve the right to use debt collection services and Smalls Claims Tribunal for failure to pay for services, including cancellation fees.

 

Assessments and Assessment Fees

Assessment package fees are set at:

1. Autism assessment and diagnostic report: $2100

2. Autism and ADHD assessment and diagnostic report: $2950

3. NDIS Access Report- from $950.

 

Other psychology assessments and reports are quoted at $330 / hr (and may incur an additional GST item).

Assessments and reports require payment up front. This is because your psychologist invests considerable time reviewing the referral, liaising with relevant health professionals, collating pre-assessment results, and individualising the diagnostic and report preparation processes for each client.

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If payment is to be covered by a third-party payer, you will be required to pay up front and organise a reimbursement from your funding body after. Neurokin Psychology does not bill third parties directly for any consultations. 

For all assessments, we require a 25% deposit to hold your spot. This is non-refundable. This fee is taken off the whole amount. 

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You will be required to complete the New Client Intake and Consent forms online at the time of booking to ensure your appointment is reserved.

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Once you pay your deposit, we have a significant amount of work to do to set up various assessments, gather informant data, and interpret the data ahead of your session with us. In the event that you cancel your appointment with us, this fee (ie- the deposit) is not refunded. 

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The remaining payment is due 7 days prior to the Interview with your psychologist.  

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If the remaining amount is not paid 7 days prior to your interview, we will cancel your appointment, and will offer your spot to other clients. We will then offer you another time. Note that we have a large number of clients waiting for an earlier assessment time, and some of them are quite urgent (NDIS applications, legal reasons, etc). 

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If you request for your appointment to be rescheduled with more than 7 days of notice, we will do this for you.  We are unable to reschedule your rescheduled appointment though- you would forfeit the deposit and any other payment made (even if you have given us more than 7 days of notice for the second time you have requested this). 

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If you cancel your rescheduled appointment with less than 7 days of notice, or do not attend, you will forfeit the full amount paid.

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Your psychologist will already have dedicated a number of hours towards collating background information for your referral, sending assessment questionnaires and reviewing data, and spending administration time with you to reschedule appointments. 

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We reserve the right to withold your assessment results/report if you have fees outstanding.

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We reserve the right to cancel your appointment if we are unable to contact you over a prolonged period- we will email and phone you multiple times to check in first. We will keep a record of this. 

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Occasionally, we need extra consultation time with you for assessments- this is rare, but does occur. In these instances, we may determine that an individual’s profile may present greater complexity for the diagnostic process than accounted for within the pre-set fees listed above. You will be asked what you would like to do, and given options. We charge at $330 per hour of time- you may need 30 minutes ($165) or 60 minutes ($330) of extra time. It's unlikely that we would need more than one extra session (ie- one hour). 

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You may also be invoiced for additional preparation time if you submit extensive background documentation to be reviewed in the context of your diagnostic service at the standard rate ($330 /hr). You have the right to decline (in writing).

We must ensure that our reports are factual and accurate.  Do not pressure us to include statements in the report, or request us to include information in the report that we do not agree with. This is the case especially with NDIS Access.

 

Reports

Reasonable amendments to assessment reports are included at no additional cost. Reasonable amendments are limited to corrections of typographical errors, spelling, preferred punctuation, grammar, formatting, and factual inaccuracies where the correct information was provided to the psychologist at the time of assessment. 

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Requests that are considered unreasonable or outside the scope of reasonable amendments will incur additional fees. Unreasonable amendment requests include, but are not limited to:

• Requests for minor wording changes that do not alter the clinical meaning of the report, including preference-based rephrasing (apart from gender pronouns) or stylistic changes;

• Requests to change sentence structure, tone, phrasing, or word choice for personal preference rather than accuracy or clarity;

• Requests to substitute synonyms, adjust descriptors, or rephrase clinically appropriate language where the original wording is already accurate and professionally standard;

• Requests to add, expand, or elaborate on information that was not provided during the assessment process;

• Requests to change, reinterpret, soften, strengthen, or remove clinical observations, professional opinions, diagnoses, or conclusions;

• Requests to alter previously provided information or to present information in a way that differs from what was reported during assessment;

• Requests to restructure the report, alter its length, or modify it to suit purposes beyond those originally agreed

• Requests that require re-reading, re-editing, or reformatting of the report despite no substantive errors being identified

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Psychological assessment reports are clinical documents prepared for the purpose of presenting assessment findings, clinical interpretation, and professional opinion. They are written by a registered psychologist and are intended to communicate relevant information clearly and accurately to the client and other professionals.

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While care is taken to ensure reports are thorough, coherent, and professionally presented, they are not editorial or design documents, nor are they intended to meet the standards of a professionally edited manual. This service does not include professional editing, proofreading, or document design.

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Requests for extensive editorial changes, stylistic preferences, formatting adjustments (including fonts, spacing, layout, or use of white space), or repeated revisions aimed at achieving a flawless or “perfect” document fall outside the scope of the assessment service and will not be accommodated.

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Reports are finalised once reasonable amendments have been considered and made. Minor formatting inconsistencies or stylistic variations may remain and do not impact the clinical accuracy or validity of the assessment.

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Unreasonable amendment requests are billed in 15-minute increments at a rate of $330 per hour.

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If you have failed to pay us for our services, we reserve the right to apply to the Smalls Claims Tribunal and/or a debt collector in order to recover costs. In this instance, we will be required to disclose basic information about you (name, DOB, address, invoice/fee information, service provided, and dates as to when provided) in order to proceed with this. We reserve the right to charge you the application fee to the Small Claims Tribunal in addition to the cost of our service, and our time to arrange this. 

 

Emergencies

Neurokin Psychology is NOT an emergency service. We are not able to respond to urgent or emergency matters and our communication channels Email is not monitored outside of standard business hours.

In case of emergency, please go to the emergency department of the nearest hospital or call 000.

 

Telehealth Psychology Services

Neurokin Psychology offers telehealth sessions delivered via videoconferencing software. Psychologists providing telehealth services apply the same ethical and professional standards of care and practice that are required when providing in-person psychology services. To participate in a telehealth service, clients will need to ensure they can log on the platform from a safe, private, comfortable environment. It is important that the person is free from distractions including children and pets. The psychologist must have emergency contact details for each client and be aware of the client’s physical location (address) at the time of the session.

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Your psychologist may ask for your consent to record a telehealth session so that the audio (conversation) can be transcribed into a written summary for the purposes of facilitating the analysis of qualitative information and subsequent diagnostic evaluation(s). If you consent, your psychologist will enable Live Transcription via the Heidi Health. You can request a copy of the transcription. The transcription will be stored within your secure client file, and will not be saved to any cloud storage platforms in order to preserve privacy and confidentiality. You will be informed before a recording takes place and can refuse to be recorded for any reason.

 

Potential benefits of telehealth consultations:

• Telehealth might:

  • Improve access to services

  • Reduce your need for travel

  • Decrease exposure to infectious disease

 

Potential risks of telehealth consultations:

• Telehealth might:

  • Be negatively impacted by technical problems, such as delays due to technology failures.

  • Not offer the same visual and sound quality for observations and modelling

  • Require you to have a support person available to assist

  • Increased exposure to privacy and digital security risks. To help with this, the practitioner must maintain confidentiality and privacy standards during sessions, and in creating, keeping and transmitting records.

 

While the practitioner is obligated to meet standards to protect your privacy and security, telecommunication, including videoconference, may increase exposure to hacking and other online risks; as with all online activities, there is no guarantee of complete privacy and security protection. You may decrease the risk by using a secure internet connection, meeting with the practitioner from a private location, and only communicating using secure channels.

 

Court / Tribunal / Mediation / Advice Policy

Neurokin Psychology does not provide any court reports/letters nor any legal advice regarding any legal matters. This includes Family Court matters regarding custody and parenting arrangements. Neurokin Psychology does not provide competency assessments, or fitness for work assessments. Neurokin Psychology does not provide assessments or reports for medico-legal purposes.

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​We reserve the right to update or modify this policy as necessary to reflect changes in our service practices or in response to evolving legal and regulatory requirements.

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Agreement 

By signing this consent form, I acknowledge that I have been made aware that even with an ADHD assessment report from a Clinical Psychologist, a Psychiatrist may want to re-do a full assessment, and I have read, understood, and agree with Neurokin Psychology's conditions of service.

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